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Some clinical studies have found elevated lactate levels (395, 396) in ME/CFS patient blood, cerebrospinal fluid, and muscles, suggesting there is reduced oxidative phosphorylation and a switch to anaerobic glycolysis (392, 397399)

The Pediatric infectious disease journal

Estey E, Cabinillas F, Rosenblum M, Kurzrock R, Bole J, Andreeff M , Keating M, Kantarjian H, Lopez-Berestein G

Cancer cells undergo RAS mutation due to inhibition endogenous apoptosis causing intrinsic cancer resistance

Annu Rev BioMed Eng

Major limitations are the various ways to assess OSI, and the lack of interpretability of the final ratio obtained [27], combined with a lack of clinical relevant large-scale studies